The spread of deaths of despair in the USA

Americans in the prime years of life—aged 25 to 44—are dying at an increasing rate, and the increase is mainly due to “deaths of despair”—drug overdoses and alcohol-related disease.

I recently wrote a post about the Case-Deaton study, which shows a rise in “deaths of despair” among white Americans, especially those age 45 to 54, since 1999.

Now reporters for the Washington Post have done their own study which shows a rise in the death rate since 2010 among Americans of all races in the prime of life—age 25 to 44.

As in the Case-Deaton study, the increase is due to “deaths of despair”—drug overdoses and alcohol-related diseases.

Since 2010, death rates have risen

16 percent for young white American adults.

18 percent for young native American adults

7 percent for young Hispanic American adults

4 percent for young African-American adults

3 percent for young Asian American adults.

Why is this happening?

The majority of Americans are doing badly economically. Wages are stagnant. Good jobs are scarce. Many have educational, medical or other debts they never will be able to pay.

Except for the professional classes and the ultra-rich, few expect to do better economically than their parents, and few expect their children to do better than themselves.

In the past generation, some of us have been sold in the idea that medications, such as Prozac, are the solution to our psychological and personal problems. A journalist named Robert Whitaker did a good job of documenting this in his book, Anatomy of an Epidemic, and his book and website, Mad in America.

This new respectable drug culture made it easy for Purdue Pharmaceuticals to market Oxycontin, an addictive pain killing prescription drug, and widespread use of Oxycontin made it easy for illegal drug traffickers to sell heroin as a cheap substitute. For some, drugs provided an easier escape from dead-end lives than individual initiative or political struggle.

The United States is a long way from the plight of Russia during the Yeltsin era, when rising death rates—also deaths of despair—and falling birth rates created a real fear that the Russian people were dying out. But if present trends continue, that’s where we Americans could wind up.

I don’t expect things to go on the way they are now. I think there will be a radical political change or a radical religious change or both. I don’t know whether it will be change for the better of change for the worse.

When writing and thinking about death rates, you have to consider the fact that the death rate is always higher among older people than younger people. Indeed, in the long run, the death rate is always 100 percent.

The United States population is getting older on average. That means, all other things being equal, that the overall death rate would rise, but that, in and of itself, wouldn’t be something to worry about.

Anne Case and Angus Deaton in their study, and the Joel Achenbach and Dan Keating of the Washington Post, got around this problem by looking at death rates in different age brackets.

Case and Deaton produced an “age-adjusted” death rate—what the death rate would have been if the age distribution had stayed the same as it was in a certain year. Even so, they were criticized by a statistician named Andrew Gelman who said the study was skewed by the changing age distribution within the 45-to-54 age group.

There are different ways of drawing statistical inferences, but, on this issue, I don’t see any differences that would affect the overall conclusion. Increasing numbers of Americans are dying because they’ve given up on life.